Twenty-six percent of working-age U.S. adults went without health insurance for at least part of 2011, often because they lost or changed jobs, according to a new report by The Commonwealth Fund.
Among those who experienced a gap in coverage, 69 percent were without health insurance for a year or longer, and 57 percent were uninsured for two years or more. The report, "Gaps in Health Insurance: Why So Many Americans Experience Breaks in Coverage and How the Affordable Care Act Will Help," is based on a tracking survey of U.S. adults.
Among those who were uninsured at the time of the survey or who had experienced an insurance gap:
- 41 percent said they previously had employer-sponsored coverage.
- 67 percent of those who lost their employer-sponsored coverage said a job loss or job change triggered the loss of coverage.
- 62 percent of those who tried to buy individual health insurance in the last three years found it very difficult or impossible to find affordable coverage.
- 31 percent were turned down, charged a higher price or had a condition excluded because of a pre-existing condition.
- 60 percent of those who tried to purchase a plan on their own said they found it very or somewhat difficult to compare the benefits provided by different plans.
- 45 percent said they never bought a plan, mainly because of cost.
The survey found a link between long insurance gaps and a lack of screening and preventive care. Ninety-two percent of working-age adults with continuous health insurance coverage reported having a regular doctor, compared to 76 percent of those who lost coverage for up to one year and 46 percent of those who were uninsured for a year or more.
Rates of preventive cancer screening were also lower for those with coverage gaps and continued to drop as people spent longer periods without insurance.
Major provisions of the Patient Protection and Affordable Care Act will help bridge health insurance coverage gaps, the report authors concluded. Under the law in 2014, more people will be eligible for Medicaid, the federal-state insurance program for low-income people, and the federal government will provide subsidies for people who meet certain income requirements to buy health insurance. In addition, health insurance companies won't be able to deny coverage or charge higher premiums based on pre-existing conditions or gender.
Whether these measures will take effect may depend on how the U.S. Supreme Court rules in a case challenging the health care reform law's constitutionality. The Supreme Court heard arguments in late March and is expected to issue a ruling in June.
The survey by The Commonwealth Fund polled 2,134 adults, including 977 who have incomes below 250 percent of the federal poverty level ($55,875 for a family of four).